We report the case of a 9-year-old Caucasian male who came to consultation complaining of sudden decrease in visual acuity (VA) in the left eye (LE).
Parents are adoptive and unaware of a history of interest.
The corrected VA is 0.7 in right eye and 0.4 in left eye.
Platelet count, intraocular pressure, and pupillary reflexes were within normal limits.
Funduscopic examination revealed a vitelliform subretinal macular lesion in both eyes.
Adjacent hemorrhage was also observed in the left eye.
Given the suspicion of NVM in this eye, fluorescein angiography (FA) was performed to confirm its existence.
Autofluorescence is also studied by observing hyperautofluorescent images acquired with lipofuscin deposits.
Optical coherence tomography (OCT) showed a hyperintense spectral lesion due to subretinal material and adjacent fluid.
1.
The study was completed with electrophysiological tests, confirming the diagnosis of suspicion in view of the pathological result of the electrooculography (E pattern), Arden coefficient being 1.34 in right eye and 1.49 in right eye.
Although not usual, electroretinogram (ERG) with pattern stimulus is also altered, probably due to the presence of NVM.
An observational control was decided, keeping the VA stable after one month.
The tendency to self-limiting choroidal NVM in young patients has already been described by Ho and Glaser, probably due to the hyperfunction of the retinal pigment epithelium (RPE) production in the circumscribed area.
On the other hand, prospective studies with definitive results on the possible adverse effects of antiangiogenic injection in younger patients have not yet been performed.
